Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.
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Today's VeTerinary PracTice | January/February 2016 | tvpjournal.com PracTice BUiLdinG 130 STAGE 2. During the Appointment The Arrival When the time for the appointment comes have the: • Paperwork ready, dated, and in the room. • room itself set up properly, and someone prepared to assist the client. • support team meet the family at their car and help them into the clinic, shuttling them to the room immediately. Paperwork is best completed at this time. The Room Whether the room is a separate comfort room or a regular examination room, make it as warm and comfortable as possible (it should not be the cold, sterile environment that owners dread). Here are some tips: • Put a large fluffy bath rug (with a rubber sole) on the ground or on the table. soft, pretty blankets and towels specific for euthanasia should be used to wrap the pet in. • Provide soft background noise, perhaps a water feature or soft music without words. • Have a basket ready with items, such as tissues, water bottles (dehydration is a common side effect of crying), a small mirror (women like to check their makeup after they have cried), a small cloth bag for the pet's collar to go in, a container to place hair clippings in, and material to make a paw print. • dim the lights, if you can. if not, have a lamp in the room and turn off the fluorescent lights. Support Team Presence The veterinarian should go into the room and preferably not leave again until the pet has passed (unless the owner requests time alone). Go in with the sedation and euthanasia solution already in syringes in your pocket or give them to your technician. speak to the client and make a visual assessment of the pet. do not pass judgement or appear to be uncomfortable with the decision unless you are certain you will not euthanize. discomfort from you or your support team could leave a family with guilt for years. if you are comfortable with the euthanasia, verbally reassure the owner that "we" are making the best decision. Explaining the Process When explaining the euthanasia process, give the owner peace of mind. explain that euthanasia Euthanasia Practice Building suggestions • Walk in with a gentle smile. Be genuinely happy to see the family and be there with them for this important moment. Greet the pet with a positive statement like, "Hi, handsome!" People have been telling this client for a long time how awful his or her pet looks, so it's a nice change for them to hear someone acknowledge the same beauty in the pet that they see. • Prime clients for a positive experience. Instead of saying, "It doesn't hurt," or "He won't be in pain," both of which use negative words, give the client positive words like, "This is a very peaceful process," and "He will be feeling much better than he's felt in a while." • You can always change your mind if you're not comfortable euthanizing a pet, but it's hard to make up for guilt the owner may feel. Be aware of the owner's body language when offering alternatives to euthanasia, and only do so if you are certain you will refuse to euthanize and/or if the client specifically asks for these alternatives. • An alternative for handling paperwork is to have the client sign the consent form after the euthanasia process is explained. • The last 15 to 30 minutes the owner has while his or her pet is still alive are precious. You would never want your pet taken from your arms at this moment, so consider not removing them from the room for IV catheter placement. Clients appreciate being involved in each part of the process, as well as not being left alone. • Knowing when to respect silence and let the owners be in the moment is a very important part of the experience for them. As Ghandi once said, "Speak only if it improves upon the silence." • Hug the owners afterward. If you're not a hugger, a gentle touch on the hand or shoulder will convey more empathy than words ever will. • Here are some useful phrases for the most common postmortem side effects: » Agonal breath: "This is just a spasm of the diaphragm, like a hiccup; it's uncommon but normal." » Twitching: "Death is a phase, not a moment, and this is normal as different areas of the body shut down." » Stretching: "This happens frequently when pets pass on their own; this tells me Max was very close to the natural dying process." E u t h a FIGURE 2. Every moment of the euthanasia appointment should take into account the bond between the owner and the pet.